Rural Health
Resources by Topic: Reimbursement and payment models
Report to Congress: Rural Community Hospital Demonstration
Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Summarizes findings from the Rural Community Hospital Demonstration (RCHD) over the twelve years authorized by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the Patient Protection and Affordable Care Act (ACA). Reports on the characteristics of the participating hospitals and the effect of the demonstration on hospital finances and other outcomes. Also discusses steps the hospitals expected to take at the end of the demonstration, if it had not been extended for an additional five years by the 21st Century Cures Act of 2016.
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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MedPAC Comment on CMS's Proposed Rule on Medicare Shared Savings Program ACOs
Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on an August 17, 2018, Federal Register proposed rule changing the Medicare Shared Savings Program (MSSP). Focuses on the proposed changes for Accountable Care Organizations (ACOs), including a move to two-sided risk models, using regional spending benchmarks, and more. Addresses potential impacts for small ACOs, which include rural ACOs.
Date: 10/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Developing Telemental Health Partnerships Between State Medical Schools and Federally Qualified Health Centers: Navigating the Regulatory Landscape and Policy Recommendations
Provides recommendations for overcoming barriers to promoting telemental health services partnerships between medical schools and health centers. Discusses rural-urban disparities in provision of mental health services, credentialing, remote electronic health records access, insurance issues, and billing.
Author(s): John C. Fortney, Richard C. Veith, Amy M. Bauer, et al.
Citation: Journal of Rural Health, 35(3), 287-297
Date: 10/2018
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Provides recommendations for overcoming barriers to promoting telemental health services partnerships between medical schools and health centers. Discusses rural-urban disparities in provision of mental health services, credentialing, remote electronic health records access, insurance issues, and billing.
Author(s): John C. Fortney, Richard C. Veith, Amy M. Bauer, et al.
Citation: Journal of Rural Health, 35(3), 287-297
Date: 10/2018
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CMS Bundled Payments for Care Improvement Initiative Models 2-4: Year 5 Evaluation & Monitoring Annual Report
Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Shares findings from an evaluation of Models 2, 3, and 4 of the Bundled Payments for Care Improvement (BPCI) initiative, linking provider payments for an episode of care with the goal of decreasing cost of care while improving quality. Includes information specific to rural BPCI-participating hospitals.
Author(s): The Lewin Group, Abt Associates, GDIT, Telligen
Date: 10/2018
Sponsoring organization: Centers for Medicare and Medicaid Services
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Ensuring Access to Quality Health Care in Vulnerable Communities
Highlights the health characteristics and conditions of vulnerable populations in rural and urban communities, and the essential healthcare services as identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. Discusses several strategies recommended by the task force to address social determinants of health, enhance virtual care services to reform healthcare delivery and payment methods, and support hospitals in their efforts to provide the needed health services.
Author(s): Jay Bhatt, Priya Bathija
Citation: Academic Medicine, 93(9), 1271-1275
Date: 09/2018
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Highlights the health characteristics and conditions of vulnerable populations in rural and urban communities, and the essential healthcare services as identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. Discusses several strategies recommended by the task force to address social determinants of health, enhance virtual care services to reform healthcare delivery and payment methods, and support hospitals in their efforts to provide the needed health services.
Author(s): Jay Bhatt, Priya Bathija
Citation: Academic Medicine, 93(9), 1271-1275
Date: 09/2018
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Rural Hospital Closures: Number and Characteristics of Affected Hospitals and Contributing Factors
Examines rural hospital closures from 2013-2017, including their financial health, hospital characteristics, and the impact on healthcare access. Compares data to 2008-2012 closures and discusses the implications for federal healthcare policies. Addresses the role of Medicare rural hospital designations, new healthcare delivery and payment models, and other rural Health and Human Services (HHS) programs. Identifies the number of rural hospitals that closed for each state.
Additional links: Full Report
Date: 09/2018
Sponsoring organization: Government Accountability Office
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Examines rural hospital closures from 2013-2017, including their financial health, hospital characteristics, and the impact on healthcare access. Compares data to 2008-2012 closures and discusses the implications for federal healthcare policies. Addresses the role of Medicare rural hospital designations, new healthcare delivery and payment models, and other rural Health and Human Services (HHS) programs. Identifies the number of rural hospitals that closed for each state.
Additional links: Full Report
Date: 09/2018
Sponsoring organization: Government Accountability Office
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MedPAC Comment on CMS's Proposed Rule on the Physician Fee Schedule and Other Revisions to Part B for CY 2019
Comment on a July 2018 Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions.
Author(s): Francis J. Crosson
Date: 09/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Comment on a July 2018 Federal Register proposed rule revising the physician fee schedule to improve payment systems for physicians and other Medicare Part B revisions.
Author(s): Francis J. Crosson
Date: 09/2018
Sponsoring organization: Medicare Payment Advisory Commission
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Innovation Center State-Based Initiatives: A Systematic Review of Lessons Learned
A synthesis of findings from 47 evaluation reports covering 12 Center for Medicare & Medicaid Innovation models with a state component. Includes information on the impact of models for rural areas and identifies barriers and challenges faced in rural areas.
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, L&M Policy Research
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A synthesis of findings from 47 evaluation reports covering 12 Center for Medicare & Medicaid Innovation models with a state component. Includes information on the impact of models for rural areas and identifies barriers and challenges faced in rural areas.
Date: 08/2018
Sponsoring organizations: Centers for Medicare and Medicaid Services, L&M Policy Research
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Advanced Primary Care: A Key Contributor to Successful ACOs
Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Reviews the literature on accountable care organizations (ACOs) regarding characteristics of successful ACOs and outcomes for cost, quality, and utilization, including literature on rural ACOs. Analyzes Medicare and National Committee for Quality Assurance (NCQA) data on ACO cost and quality outcomes to assess the role of advanced primary care models such as patient-centered medical homes on ACO success.
Additional links: Executive Summary, White Paper
Author(s): Yalda Jabbarpour, Megan Coffman, Andy Habib, et al.
Date: 08/2018
Sponsoring organizations: Primary Care Collaborative, Robert Graham Center
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Evaluation of the Accountable Care Organization Investment Model: AIM Impacts in the First Performance Year
Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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Evaluation examining the first year performance of the 47 Accountable Care Organizations (ACOs) participating in the ACO Investment Model (AIM), which tests the use of prepaid shared savings to encourage new ACOs to form in rural and underserved areas (Test 1) and to encourage current Medicare Shared Savings Program ACOs to transition to arrangements with greater financial risk (Test 2). Describes provider characteristics, beneficiary characteristics, and impacts of the 41 Test 1 AIM ACOs. Includes data on rurality for both Test 1 and Test 2 AIM ACOs.
Additional links: Appendices, Findings At-A-Glance
Date: 08/2018
Sponsoring organizations: Abt Associates, Centers for Medicare and Medicaid Services
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